UNDERSTANDING TEENAGE DRUG USE Dr DES CORRIGAN Sligo Oct 13 th 2012
LAST MONTH USE (CURRENT USE) Drug Left School Early Still in School National Survey (18-64) Cigarettes 70% 27% 28% Alcohol 66% 56% 71% Cannabis 34% 8% 3% Headshop Drugs 3% 0.2% 3.5%* Cocaine 5% 0.2% 0.5% Ecstasy 7% 0.2% 0.1% Solvents 0.8% 0% 0.1% * USE IN LAST YEAR
OUR FAVOURITE DRUG
The Pharmacology of Alcohol Alcohol is unique because it acts as a Stimulant Drug: Risky behaviour magnified Anti-Anxiety Drug: Inhibitory mechanisms removed Pain Killing Drug: Increased aggression Depressant Drug : Inappropriate responses Because of these effects it has a major role in violent crime
Effect of ALCOHOL on the Brain 3-4 Drinks Affects Self- Control & Judgement 5-6 Drinks Affects the Senses 1-2 Drinks Affects Reason, Caution, Intelligence & memory 7-8 Drinks Affects Coordination & Balance 10 or more Affects the Vital Centres
Gender and B.A.C Content (Legal Limit 0.05%) Male 2 pints Guinness 0.11% Female 2 glasses wine 0.12% Male 4 pints Guinness 0.24% Female 4 glasses wine 0.32% Source Irish Times Motor Supplement Nov. 15 th 2006
ALCOHOL-RELATED HARMS
Alcohol Related Problems 2. Psychological Depression Suicide Anxiety Amnesia Insomnia Impaired Relationships
Alcohol Related Problems 3. Social Presenteeism Violence Drunk Driving Theft Unwanted Pregnancies Gateway link between Binge-drinking & illicit drugs
BINGE DRINKING
Cannabinoids PhytoCannabinoids- only in Cannabis plants Endocannabinoids naturally occurring in the Human Body Synthetic Cannabinoids developed as painkilling drugs found in some SPICE -type smoking mixtures
The Complexity of Cannabis 500 different Chemicals in Cannabis plants 70 Cannabinoids Most relevant: THC Euphoriant/ Psychotogenic CBD Anti-Anxiety/Anti-psychotic 3 Visually identical Cannabis plants Fibre (Hemp) Type Rich in CBD Almost no THC Drug Type: Intermediate Type: Rich in THC almost no CBD THC + CBD Equal amounts
TYPES OF CANNABIS DRUGS Herb (1-2%) ( Grass, Marijuana) Resin (10%) ( Hash,Hashish) Oil ( Hash Oil)30-60%
High THC-Content Cannabis & Headshops 1. Sale of Skunk-type seeds 2. Advice on Sinsemilla Technique 3. Sale of Hydroponics & Intense Lighting
Afghan No 1
HYDROPONIC CULTIVATION HYDROPONIC CULTIVATION
SKUNK or WEED Home-Grown or from Grow Houses Huge Increase in level of THC No CBD to counterbalance THC Increases mental health risks Increases addiction risks HASH Contains both THC & CBD
Cannabis Potency expressed as % THC Content Ireland Herb 8% (4-16%*) Hash 3% UK Herb* 12-18% Hash 3% Netherlands Herb* 16.5% Hash 30% * Skunk or Weed-type
Cannabis V Alcohol Benchmarking risk of a pint vs a joint not possible As you are not comparing like with like Because exposure levels different Because speed of elimination different Because mode of action in Brain different
The Speed at Which Drugs Leaves the Body Amount left in body after a single dose Alcohol Marijuana 1 Hour 6 Hours 30 Days
SHORT TERM EFFECTS OF CANNABIS DRUGS Memory & Learning Reactions & Coordination
Cannabis, Learning & Memory All tests of learning disrupted High levels of distractability While learning While driving While using complex machinery Solowij 1998 Cannabis use 20 + times per month: 19% more short-term memory Problems than non-users. Rodgers et al 2003
CANNABIS USE & SCHOOL PERFORMANCE Monshouwer et al 2006 Dutch Children (12 16) Those using Cannabis reported lower than average school performance. Ferguson et al 2003. (New Zealand) Cannabis use may act to decrease educational achievement in young people Lynskey and Hall 2000 (Australia) Early Cannabis use may significantly increase risks of subsequent poor school performance. Patton et al 2007(Australia) Drug of choice for life s future losers
Cannabis Use & Later Life Outcomes New Zealand Study from Birth to Age 25 High levels of use associated with Poorer educational outcomes Lower income Greater welfare dependence Greater unemployment Lower relationship & life satisfaction
** Regular Cannabis use results in a 6 point drop in IQ Meier et al Proc Nat Acad Sci August 27 th 2012
Cannabis and Driving THC impairs psychomotor function and driving performance. RECENT use of THC doubles risk of fatal crash. Damaging effects most likely on motorways and in single vehicle crashes. Combined use of THC and Alcohol produces more severe driving impairment.
CHRONIC EFFECTS OF CANNABIS DRUGS Respiratory Problems Gateway Drug Dependence Mental health
Tolerance CRITERIA FOR CANNABIS Withdrawal symptoms Loss of control over use Persistent desire to use DEPENDENCE Great deal of time spent obtaining, using and or recovering from use Giving up or reducing other important activities Continued use despite physical or psychological problems Complaints by spouse/partner about use and its effects.
CANNABIS WITHDRAWAL CRITERIA Common Symptoms Anger or aggression Decreased appetite or weight loss Irritability Nervousness/anxiety Restlessness Sleep difficulties Strange dreams Budney et al Am. J. Psychiat.2004
Cannabis Dependence Questions Did you think your use was out of control? Did the prospect of missing a joint make you anxious or worried? Did you worry about your use of Cannabis? Did you wish you could stop using? How difficult did you find it to stop or go without? NACD Population Survey 2010/2011
Adolescents who use Cannabis 1 in 6 may develop dependence ( 1 in 10 for adults) More likely to use other drugs Perform poorly at school Leave school early Report psychiatric symptoms & disorders ( Wayne Hall, Addiction Summer 2008)
Typical Scenario Young Man 17 yrs old Primary drug weed ( smokes 10-15 joints a day) Lack of motivation-drop out school & youth centre Self harm/suicidal thoughts Dysfunctional background Enablement from parent who is also chemically dependent & violent Drug Debts & threats of violence
The Adolescent brain a work in progress Blue colour represents grey matter in brain Giedd et al, 1999, Nature Neuroscience, 2, 861-863
Cannabis & Mental Health Risk Factors Genetic susceptibility (11 x Risk) Childhood Trauma (21 x Risk) Age of first use 15 years -4.5 x Risk Length of use Amount used Type of Cannabis used (Skunk/Weed) Di Forti et al Neuroscience & Biobehavioural Reviews 2011
Skunk-Type Cannabis & Psychosis Use for 5 years 2 x risk Daily use - 6 x risk Compared to Hash smoking controls Skunk use - 7 x risk Daily Skunk use - 12 x risk Di Forti et al. Br. J. Psychiatry 2009
Cannabis & Mental Health There is now sufficient evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life. Moore etal The Lancet 2007; 370: 319-28
NACD STUDY RISK FACTORS SUBSTANCE USE BY OTHER FAMILY MEMBERS FRIENDS WHO USE DRUGS EARLY EXPERIMENTATION WITH ALCOHOL & TOBACCO LOW SELF-ESTEEM
NACD STUDY PROTECTIVE FACTORS PARENTAL INVOLVEMENT & CONCERN INFORMATION ON SUBSTANCE USE FOR PARENTS FRIENDS WHO DON T USE DRUGS POSITIVE SCHOOL EXPERIENCE